Treating elopement without extinction in a preschool setting

Elopement is a prevalent and dangerous behavior that is common with children with autism spectrum disorder (ASD). Due to safety, logistics, and effort on the part of stakeholders, recent research has emphasized the need for treatments that do not include extinction or response blocking. Using a multiple-baseline-across-functions design, we successfully decreased elopement with functional communication training, without additional treatment components, for one function but needed to add an additional treatment component (response blocking) for the second function for a 4 year-old boy with ASD who engaged in elopement in a preschool setting. We highlight contributions to the literature on elopement as well as directions for future research.     

Functional analysis and treatment of elopement.

Elopement is a dangerous behavior because children who run away may encounter life-threatening situations (e.g., traffic). We conducted functional analyses of the elopement of 3 children who had been diagnosed with developmental disabilities. The results identified a maintaining reinforcer for the elopement of 1 child, but the data were difficult to interpret for 2 of the children. Subsequent reinforcer assessments were used to help to clarify the reinforcers for elopement for these 2 children. Results of the functional analyses and reinforcer assessments then were used to develop successful treatments to reduce elopement. The findings are discussed in terms of (a) the application of functional analysis methodology to elopement, (b) the use of reinforcer assessments to identify potential reinforcers when standard functional analyses are undifferentiated, and (c) the utility of assessment-based treatments for elopement.     

Treatment of elopement following a latency‐based interview‐informed,synthesized contingency analysis

Using a latency measure during a functional analysis of problem behavior increases the brevity of the assessment period and decreases risks resulting from exposure to contexts intended to evoke problem behavior. In addition, latency‐based functional analyses may be especially suitable for discrete behaviors such as elopement, which require resetting the environment after each instance of the response. We evaluated a comprehensive assessment and treatment package for the elopement of two children diagnosed with autism. We observed short latencies to elopement during the test condition of the analysis and no elopement during the control condition. We then taught the participants multiple forms of functional communication responses of increasing complexity while elopement was blocked. This was followed by the thinning of reinforcement to a terminal goal, creating a treatment package that nearly eliminated elopement and was socially validated by caregivers.     

BRIEF REPORT: LATENCY FUNCTIONAL ANALYSIS OF ELOPEMENT

Elopement is a potentially dangerous problem behavior prevalent among individuals with developmental disabilities. However, functional analysis of elopement presents unique challenges including potential confounds because of the need for participant retrieval during functional analysis sessions. In the current study, we implemented a latency functional analysis with an eight‐year‐old child with an intellectual disability, in which the dependent measure was latency to elopement. Following the latency functional analysis, a functional communication intervention was developed and its effectiveness in decreasing elopement was evaluated using an ABAB design. Findings suggest that a functional analysis of latency may be a suitable methodology to identify the operant function of elopement. Copyright © 2013 John Wiley & Sons, Ltd.     

Assessment and treatment of elopement: a replication and extension

The current investigation replicated and extended the assessment and treatment methodology of elopement. The environmental variables that maintained elopement were identified in each case, and successful treatments were implemented for the 3 participants in settings that were similar to those in which elopement occurred.     

Assessment and treatment of elopement maintained by chase

Elopement can have serious or fatal consequences associated with leaving the presence of an adult or getting lost (e.g., traffic injury and drowning). Given the dangers associated with elopement, caregivers are likely to chase after their child when elopement occurs. Like other forms of attention that follow problem behavior, chasing and retrieving the child may serve as a reinforcer and therefore maintain elopement. However, no study to date has evaluated whether elopement is sensitive to positive reinforcement in the form of chase. We evaluated the effects of chase on elopement with an 8‐year old boy diagnosed with autism. Elopement was maintained, at least in part, by chase. We then conducted a treatment evaluation in which we tested the effects of various antecedent‐ and consequence‐based treatment components within a multiple schedule.     

FUNCTIONAL ANALYSIS AND TREATMENT OF ELOPEMENT ACROSS TWO SCHOOL SETTINGS

The elopement of a child with Asperger syndrome was assessed using functional analyses and was treated in two school settings (classroom and resource room). Functional analyses indicated that elopement was maintained by access to attention in the resource room and obtaining a preferred activity in the classroom. Attention- and tangible-based interventions were compared in an alternating treatments design in both settings. Results validated the findings of the functional analyses. Implications for the assessment and treatment of elopement are discussed.     

Response latency as a measure of behavior in the assessment of elopement

Elopement is a common form of problem behavior but is relatively underrepresented in the functional analysis literature. One barrier to assessing elopement experimentally is the need to retrieve the subject following an instance of elopement. This retrieval confounds programmed session contingencies when the goal is to obtain repeated measurement of free‐operant behavior. The current study evaluated latency to elopement as an alternative to free‐operant measurement. We first compared response latency to allocation in 5‐min sessions and then measured latency alone in a trial‐based format. The identified reinforcers matched across both data analysis modalities in the session‐based assessments, and the trial‐based functional analysis showed a significant time savings in identifying the function of behavior over a session‐based assessment. Results indicated that elopement serves idiosyncratic social functions in young children with intellectual and developmental disabilities, and that a latency‐based assessment saves time while yielding equally clear results.     

Evaluating a treatment without extinction for elopement maintained by access to stereotypy

Elopement is a common and potentially dangerous form of problem behavior. Results of a functional analysis found that the elopement of a child with autism was maintained by access to stereotypy in the form of door play. We implemented functional communication training and contingency-based delays dependent on the absence of elopement and increased the amount of time the participant waited prior to engaging in stereotypy. We also conducted treatment-extension probes, with the participant waiting up to 10 min without elopement.     

Functional analysis and treatment of elopement for a child with attention deficit hyperactivity disorder

We conducted a functional analysis of elopement in an outdoor setting for a child with a diagnosis of attention deficit hyperactivity disorder. A subsequent treatment consisting of noncontingent attention and time-out was demonstrated to be effective in eliminating elopement. Modifications of functional analysis procedures associated with the occurrence of elopement in a natural setting are demonstrated.     

Assessment and treatment of elopement maintained by access to stereotypy

We evaluated a treatment for elopement maintained by access to stereotypic door play. First, we conducted a functional analysis of elopement that produced undifferentiated results. Next, we conducted an assessment in which we evaluated the relation between elopement and door play. Results suggested a functional relation between the 2 behaviors (i.e., elopement was maintained by contingent access to door play). Finally, we implemented functional communication training as a treatment for elopement in which access to door play was made contingent on a target appropriate communication response.     

Brief functional anlaysis and treatment of elopement in preschoolers with autism

As a result of the impact of functional analysis methodologies in identifying maintaining variables of problem behavior, considerable research has been devoted to tailoring the methodologies to be practical for an outpatient setting. The purpose of this study was (a) to use brief functional analysis (BFA) methodologies to empirically demonstrate the function of elopement exhibited by two preschoolers diagnosed with autism and (b) to develop function‐based interventions derived from the results of the BFA. In phase one, a BFA consisting of 5‐min sessions with multiple repetitions of each condition was conducted with each participant. In phase two, the efficacy of function‐based interventions was assessed using a pairwise design. Both participants' rates of elopement were differentially lower during the implementation of the function‐based intervention relative to baseline. Collectively, these results demonstrated that brief functional methodologies could be applied successfully to the assessment and treatment of elopement. Moreover, the application of BFA and the ensuing treatment in an outpatient setting extend the existing research on functional analysis. Copyright © 2008 John Wiley & Sons, Ltd.     

The effect of a conditioned fear inhibitor (CS-) during response prevention upon extinction of an avoidance response

Pairing a Pavlovian safety signal (CS—) with a response prevention period was contrasted with other response prevention procedures to determine relative effectiveness for the elimination of learned avoidance behavior. After acquiring a one-way avoidance response, five groups of ten rats received various blocking or control treatments and were then compared on extinction performance. The four blocking treatments included blocking paired with a safety signal; blocking only; blocking paired with a novel stimulus; and blocking paired with a preexposed noncontingent tone. The fifth group served as a handling control. Compared to the handling control, all four blocking groups reached extinction criterion in fewer trials. Further, the safety signal group extinguished faster than the blocking only group or the blocking with noncontingent tone group. Results were viewed as an indication of the potential efficacy of pairing-conditioned fear-inhibiting cues with response prevention procedures for the elimination of fear-motivated behavior. Implications for behavioral therapy techniques were discussed.     

The effects of two response-elimination procedures on reinforced and induced aggression.

Pecks against a stuffed pigeon were reinforced according to a fixed-interval schedule for one group of pigeons and a variable-interval schedule for a second group. Red and green stimulus lights were alternately illuminated. Subsequently, food deliveries no longer occurred during one color (extinction). In the presence of the other color, food was presented only when no attack occurred for 30 sec. When attack produced food, all pigeons generally exhibited characteristic fixed-interval or variable-interval response patterns. Two birds in each group frequently exhibited postreinforcement schedule-induced aggression. Attack was reduced to low levels at approximately the same rate by extinction and differential reinforcement of other behavior. For birds that had previously exhibited schedule-induced aggression the initial reduction of attack during the second experimental phase was followed by induced attack immediately after food delivery in the differential-reinforcement-of-other-behavior component and upon onset of the extinction component, Either extinction or differential reinforcement of other behavior may eliminate reinforced aggression but may be relatively ineffective for reducing induced attack.     

An evaluation of resurgence following functional communication training conducted in alternative antecedent contexts via telehealth

Treatments based on differential reinforcement may inadvertently increase the recurrence of problem behavior in the face of challenges because reinforcers for appropriate behavior occur in the same context as problem behavior. The current study evaluated one potential approach to mitigating these problems with differential reinforcement treatments based on behavioral momentum theory. Specifically, appropriate behavior was trained in contexts without a history of reinforcement prior to intervening with problem behavior. Participants were 4 children with autism spectrum disorder. Treatment used telehealth to implement functional communication training (FCT) in three alternative contexts with minimal or no history of reinforcement for problem behavior before initiating FCT in the treatment context. Evaluations of the effects of treatment and tests of resurgence were conducted intermittently during treatment to evaluate maintenance. When FCT treatment was initiated in alternative contexts, initial results were comparable to more typical implementations of FCT. Resurgence was reduced to similar levels during tests of resurgence for all participants when compared to more typical previously published implementations of FCT, but clinically significant reductions in resurgence occurred more quickly in the present study. These findings support training appropriate behavior in an alternative context to mitigate the resurgence of problem behavior during differential reinforcement treatments.     

A comparison of differential reinforcement procedures for treating automatically reinforced behavior

Children diagnosed with autism spectrum disorder (ASD) often exhibit stereotypy, which can be socially stigmatizing, interfere with daily living skills, and affect skill acquisition. We compared differential reinforcement of alternative behavior (DRA) and differential reinforcement of other behavior (DRO) when neither procedure included response blocking or interruption for (a) reducing stereotypy, (b) increasing task engagement, and (c) increasing task completion. DRA contingencies yielded superior outcomes across each measure when evaluated with 3 individuals with autism spectrum disorder.     

Signaled alternative reinforcement and the persistence of operant behavior

Differential reinforcement of alternative behavior (DRA) is a treatment designed to eliminate problem behavior by reinforcing an alternative behavior at a higher rate. Availability of alternative reinforcement may be signaled, as with Functional Communication Training, or unsignaled. Whether or not alternative reinforcement is signaled could influence both the rate and persistence of problem behavior. The present study investigated whether signaling the availability of alternative reinforcement affects the rate and persistence of a concurrently available target response with pigeons. Three components of a multiple concurrent schedule arranged equal reinforcement rates for target responding. Two of the components also arranged equal reinforcement rates for an alternative response. In one DRA component, a discrete stimulus signaled the availability of response‐contingent alternative reinforcement by changing the keylight color upon reinforcement availability. In the other DRA component, availability of alternative reinforcement was not signaled. Target responding was most persistent in the unsignaled DRA component when disrupted by satiation, free food presented between components, and extinction, relative to the signaled DRA and control components. These findings suggest the discrete stimulus functionally separated the availability of alternative reinforcement from the discriminative stimuli governing target responding. These findings provide a novel avenue to explore in translational research assessing whether signaling the availability of alternative reinforcement with DRA treatments reduces the persistence of problem behavior.     

Differential Reinforcement of Alternative Behavior in Center-Based Classrooms: Evaluation of Pre-teaching the Alternative Behavior

This study investigated the effectiveness of a differential reinforcement of alternative behavior procedure in decreasing disruptive behavior while simultaneously increasing the appropriate behavior of four children of typical development between the ages of 4 and 6 in center-based classrooms. We began with brief functional analyses for each child. Then, differential reinforcement procedures, with and without pre-teaching the alternative behavior, were compared using an alternating treatments design. Results indicated that the differential reinforcement procedure with pre-teaching resulted in lower levels of problem behavior and greater levels of the alternative behavior compared to differential reinforcement alone. Results are discussed in terms of implications for applied practice and functional assessment and intervention research.     

Stimulus Fading and Response Elaboration in Differential Reinforcement for Alternative Behavior

A hallmark of applied behavior analysis is the development of function‐based interventions for problem behavior. A widely recommended function‐based intervention is differential reinforcement of alternative behavior (DRA), in which reinforcement is contingent upon socially acceptable alternatives to problem behavior (e.g., teaching communication skills). Typically, DRA is introduced under rich schedules of reinforcement. Although effective for initiating behavior change, rich schedules are often impractical in the natural setting. In this study, we evaluated the extent to which a stimulus fading program could be employed to elaborate alternative behavior (mands) in two individuals diagnosed with an autism spectrum disorder. For both participants, problem behavior was reduced substantially upon implementation of the DRA procedure. Further, problem behavior rates remained low and mand rates decreased to more practical levels as the DRA behavioral requirements increased during the fading program. The fading approach demonstrated in this paper may be a useful component of intervention packages for clinicians. Copyright © 2015 John Wiley & Sons, Ltd.     

Analysis of self-recording in self-management interventions for stereotypy

Most treatments for stereotypy involve arrangements of antecedent or consequent events that are imposed entirely by a therapist. By contrast, results of some studies suggest that self-recording, a common component of self-management interventions, might be an effective and efficient way to reduce stereotypy. Because the procedure typically has included instructions to refrain from stereotypy, self-recording of the absence of stereotypy, and differential reinforcement of accurate recording, it is unclear which element or combination of elements produces reductions in stereotypy. We conducted a component analysis of a self-management intervention and observed that decreases in stereotypy might be attributable to instructional control or to differential reinforcement, but that self-recording per se had little effect on stereotypy.